{"title":"Significance of Serum Leucine-rich Alpha-2 Glycoprotein as a Diagnostic Marker in Pediatric Inflammatory Bowel Disease.","authors":"Shohei Yoshimura, Yuichi Okata, Makoto Ooi, Tomoko Horinouchi, Serena Iwabuchi, Yasuyuki Kameoka, Aya Watanabe, Atsushi Kondo, Kotaro Uemura, Yuichiro Tomioka, Yoshitomo Samejima, Yumiko Nakai, Kandai Nozu, Yuzo Kodama, Yuko Bitoh","doi":"10.24546/0100486228","DOIUrl":"10.24546/0100486228","url":null,"abstract":"<p><p>Serum leucine-rich alpha-2 glycoprotein (LRG) has been utilized for adult inflammatory bowel disease (IBD); however, its efficacy in pediatric IBD remains unknown. The aim of this study was to compare the diagnostic accuracy of serum LRG for pediatric IBD with that of current inflammatory markers, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). This retrospective case-control study included pediatric patients, aged <16 years, who underwent colonoscopy and/or esophagogastroduodenoscopy between April 2017 and March 2022. All eligible patients were divided into two groups: patients with IBD, diagnosed with ulcerative colitis and Crohn's disease, and non-IBD controls. The optimal cut-off value of serum LRG for IBD diagnosis was determined from receiver operating characteristic analysis, and diagnostic accuracy of serum LRG was compared to serum ESR and CRP. A total of 53 patients (24 with IBD and 29 non-IBD controls) met the inclusion criteria. The cut-off value of serum LRG for IBD diagnosis was determined to be 19.5 μg/ml. At this cut-off value, serum LRG had a positive predictive value (PPV) of 0.80 and negative predictive value (NPV) of 0.88. In contrast, PPV and NPV were 0.78 and 0.70 for serum ESR and 0.82 and 0.72 for serum CRP, respectively. Serum LRG can be a potential diagnostic marker for pediatric IBD, with higher diagnostic accuracy than that of the conventional serum markers ESR and CRP.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 4","pages":"E122-E128"},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Outcome of Mandibular Distraction Osteogenesis in Infants with Severe Pierre Robin Sequence in Vietnam.","authors":"Dang Hoang Thom, Vu Ngoc Lam, Tran Thiet Son","doi":"10.24546/0100485260","DOIUrl":"10.24546/0100485260","url":null,"abstract":"<p><p>The purpose of this study was to provide the experience of a single center with mandibular distraction osteogenesis (MDO) in Pierre Robin Sequence (PRS) patients. A longitudinal research analysis was conducted to identify PRS patients who underwent MDO at Vietnam National Children's Hospital between 2019 and 2021. The following criteria were used to determine inclusion: 1) those pediatric patients with PRS who were not well handled with conservative therapy, 2) those who received MDO with internal mandibular distractors, and 3) no previous treatment elsewhere. Demographic data, postoperative complications, and surgical results were all evaluated. The inclusion criteria were met by 73 patients. There were no difficulties associated with our distraction strategy. The majority of individuals with tracheostomies were successfully decannulated, and the remainder were able to avoid tracheostomies. Using MDO in PRS is an effective technique to avoid future airway issues. The success rate was lower and the complication rate higher for patients who had a tracheotomy before distraction and for those who underwent distraction at an age older than 2 months. The presence of laryngomalacia, gastric reflux disease, cardiac abnormalities, and GI anomalies did not increase the likelihood of MDO failure in PRS patients.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 3","pages":"E115-E121"},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of Mandibular Distraction Osteogenesis on Cephalometric Measurements in Infants with Pierre Robin Sequence.","authors":"Dang Hoang Thom, Vu Ngoc Lam, Tran Thiet Son","doi":"10.24546/0100485259","DOIUrl":"10.24546/0100485259","url":null,"abstract":"<p><strong>Background: </strong>The obstruction of the upper airway (UAO) in infants diagnosed with Robin Sequence (RS) is caused by micrognathia, and in severe cases, it can result in obstructive sleep apnea (OSA). Mandibular distraction osteogenesis (MDO) is a secure and efficient remedy for significant UAO. However, there is insufficient data on the related cephalometric changes. Therefore, this study meticulously analyzes the mandibular cephalometric changes in infants with RS who have undergone MDO using internal devices. The aim is to gain a more comprehensive understanding of the short- and long-term impacts of distraction on the mandible.</p><p><strong>Methods: </strong>The study examined 73 consecutive cases of mandibular distraction osteogenesis (MDO) performed by a single surgeon. Preoperative and postoperative lateral cephalograms, as well as CT scans of the mandible, were utilized to assess population averages for both time points. A two-sample T-Test with equal variance was used for this analysis.</p><p><strong>Results: </strong>After the MDO procedure, 19 out of 21 cephalometric parameters exhibited significant morphological changes. On average, there were notable improvements of 20.3 mm (60.7%) in length, 9.8 mm (49.7%) in height, 12.6 mm (36.1%) in width, and 211% in airway parameters. However, most parameters showed only mild regression at the time of device removal and 6 to 12 months post-MDO. Nonetheless, the cephalometric parameters remained significantly improved compared to the preoperative measurements.</p><p><strong>Conclusions: </strong>The use of cephalometric measurement is a potent approach that provides a clear and measurable understanding of how MDO influences both immediate and long-term growth of the mandible. This quantitative assessment of the effects of mandibular distraction allows for the refinement of surgical techniques and the optimization of outcomes. Therefore, incorporating cephalometric measurements in the evaluation of patients undergoing MDO can lead to better surgical planning and more favorable results.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 3","pages":"E106-E114"},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute Amelioration of Inflammatory Activity Caused by Endothelin-2 Deficiency during Acute Lung Injury.","authors":"Ahmad Musthafa, Gusty Rizky Teguh Ryanto, Ratoe Suraya, Tatsuya Nagano, Yoko Suzuki, Tetsuya Hara, Ken-Ichi Hirata, Noriaki Emoto","doi":"10.24546/0100483406","DOIUrl":"10.24546/0100483406","url":null,"abstract":"<p><p>In acute lung injury (ALI), a severe insult induces a hyperinflammatory state in the lungs. The mortality rate of severe ALI remains high, and novel mechanistic insights are required to improve therapeutic strategies. Endothelin-2 (Edn2), the least studied isoform of endothelin, is involved in lung physiology and development and can be affected by various factors. One of them is inflammation, and another isoform of endothelin, endothelin-1 (Edn1), affects lung inflammatory responses. Considering the importance of Edn2 in the lungs and how Edn2 works through the same receptors as Edn1, we postulated that Edn2 may affect inflammatory responses that are central to ALI pathophysiology. In this study, we performed 24 hours intratracheal lipopolysaccharide (LPS) instillation or PBS control as an in vivo ALI model in eight-week-old conditional Edn2 knockout mice (Edn2-iKO), with Edn2-floxed mice as controls. Bronchoalveolar lavage (BAL) fluid and tissue were collected after exsanguination and analyzed for its cellular, molecular, functional, and histological inflammatory phenotypes. We found that Edn2-iKO mice displayed a reduced pro-neutrophilic inflammatory phenotype even after acute LPS treatment, shown by the reduction in the overall protein concentration and neutrophil count in bronchoalveolar lavage fluids. Further investigation revealed a reduction in mRNA interferon gamma (IFNγ) level of Edn2-iKO lungs and suppression of its downstream signaling, including phosphorylated level of STAT1 and IL-1β secretion, leading to reduced NFĸB activation. To conclude, Edn2 deletion suppressed acute lung inflammation by reducing neutrophil-mediated IFNγ/STAT1/IL-1β/NFĸB signaling cascade. Targeting Edn2 signaling may be beneficial for the development of novel treatment options for ALI.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 3","pages":"E96-E105"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71524091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum: Influences of Orogastric and Nasogastric Tubes on Sucking Pressure during Bottle Feeding in Immature Infants.","authors":"Takeshi Komatsu, Tatsuya Furukawa, Daisuke Kobayashi, Sota Iwatani, Seiji Yoshimoto, Toshihiko Yamashita, Yumi Endo, Sayaka Katsunuma, Masahide Otsu, Ken-Ichi Nibu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This corrects the article in Kobe J Med Sci. 2023 May 31; 69(1): E25-E32.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 1","pages":"S1"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adi Ariffianto, Lin Deng, Saki Harada, Yujiao Liang, Chieko Matsui, Takayuki Abe, Ikuo Shoji
{"title":"Transcription Factor JunB Suppresses Hepatitis C Virus Replication.","authors":"Adi Ariffianto, Lin Deng, Saki Harada, Yujiao Liang, Chieko Matsui, Takayuki Abe, Ikuo Shoji","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We previously reported that hepatitis C virus (HCV) infection activates the reactive oxygen species (ROS)/c-Jun N-terminal kinase (JNK) signaling pathway. Activation of JNK contributes to the development of liver diseases, including metabolic disorders, steatosis, liver cirrhosis and hepatocellular carcinoma. JNK is known to have numerous target genes, including JunB, a member of activator protein-1 transcription factor family. However, the roles of JunB in the HCV life cycle and HCV-associated pathogenesis remain unclear. To clarify a physiological role of JunB in HCV infection, we investigated the phosphorylation of JunB in HCV J6/JFH1-infected Huh-7.5 cells. Immunoblot analysis revealed that HCV-induced ROS/JNK activation promoted phosphorylation of JunB. The small interfering RNA (siRNA) knockdown of JunB significantly increased the amount of intracellular HCV RNA as well as the intracellular and extracellular HCV infectivity titers. Conversely, overexpression of JunB significantly reduced the amount of intracellular HCV RNA and the intracellular and extracellular HCV infectivity titers. These results suggest that JunB plays a role in inhibiting HCV propagation. Additionally, HCV-mediated JunB activation promoted hepcidin promoter activity and hepcidin mRNA levels, a key factor in modulating iron homeostasis, suggesting that JunB is involved in HCV-induced transcriptional upregulation of hepcidin. Taken together, we propose that the HCV-induced ROS/JNK/JunB signaling pathway plays roles in inhibiting HCV replication and contributing to HCV-mediated iron metabolism disorder.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 3","pages":"E86-E95"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gender Disparities in First Authorship at Three Medical Universities in an Area Affected by the Great East Japan Earthquake.","authors":"Yuko Ono, Masafumi Saito, Kenju Shimomura, Kazuaki Shinohara, Naoto Yamada, Yudai Iwasaki, Shigeaki Inoue, Joji Kotani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Great East Japan Earthquake that occurred on March 11, 2011, was one of the largest natural disasters in modern times. Publication in medical journals is important aspects of the academic promotion process, and is thus important for all scientists. However, little is known about whether and how substantial natural disasters affect gender disparities in academic productivity in disaster-affected areas. We hypothesized that the Great East Japan Earthquake widened the existing disparities in scientific publishing between male and female researchers. To test this hypothesis, this retrospective observational study using existing databases was conducted. We extracted from the MEDLINE database all types of biomedical articles published from March 11, 2007, to March 11, 2015, by three medical universities in a disaster-affected area of Japan. Differences in the proportion of female first authorship during the 4 years before and after the Great East Japan Earthquake were compared. A total of 5,873 papers were analyzed. The proportion of female first authors significantly declined after the Great East Japan Earthquake (20.5% vs. 14.1%; odds ratio 0.64; 95% confidence interval 0.56-0.73). A similar trend was identified across all prespecified subgroups, including clinical department; original article; public medical university; and prestigious journal with impact factor >6. Reference data from two medical universities minimally affected by the Great East Japan Earthquake showed the opposite trend. These results collectively suggest that large natural disasters can reinforce existing gender disparities in first authorship in biomedicine.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 2","pages":"E64-E78"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501759/pdf/kobej-69-e64.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10261372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takeshi Ninchoji, Masayo Okuno, Tomoko Kihara, Shigeki Takekida, Jun Maruyama
{"title":"Current Status and Problems of Newborn Infection Management at a Regional Hospital in Japan.","authors":"Takeshi Ninchoji, Masayo Okuno, Tomoko Kihara, Shigeki Takekida, Jun Maruyama","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify neonatal bacterial infection management in near term and term infants at a regional hospital in Japan.</p><p><strong>Methods: </strong>Between 2018 and 2020, of 729 births, 236 patients who underwent blood examination at least twice by the age of 3 days, were included. Data from the medical records were analyzed retrospectively.</p><p><strong>Results: </strong>Median gestational age was 39 weeks, with 116 boys (49.1%) and 202 vaginal deliveries (85.6%). There were 37 cases of maternal group B streptococcus, 24 cases of premature rupture of membranes for more than 24 hours (PROM group), and 107 cases of amniotic fluid turbidity at birth (AFT group). Comparing groups, C-reactive protein (CRP) was significantly lower in the cesarean section (C/S) group (median 0.22 mg/dL; p < 0.05), and higher in the AFT group (0.44 mg/dL; p < 0.05). There were 77 positive cultures, (p < 0.05). Antibiotics were administered more frequently in cesarean section (19 cases; p < 0.001) and less in the PROM group (2 cases; p < 0.01).</p><p><strong>Conclusions: </strong>There were no asymptomatic cases of CRP >2 mg/dL, and no cases of severe sepsis in normal neonatal deliveries. CRP levels were elevated in the AFT group, where culture was positive, but few antibiotics were administered. In the C/S group, antibiotics were administered if respiratory symptoms occurred unless the CRP level was high. Further, all patients in PROM group who received antibiotics had any symptoms, suggesting that routine blood tests may not be necessary.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 3","pages":"E79-E85"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term Survival after Treatment of Synchronous Isolated Right External Iliac Lymph Node Metastasis from Ascending Colon Cancer: A Case Report.","authors":"Yuki Okazoe, Satoshi Omiya, Takahiro Nakajima, Atsuhiko Kishi, Masahiro Kido, Satoshi Suzuki, Tsunenori Fujita, Masakazu Ohno","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Synchronous isolated external iliac lymph node metastasis of ascending colon cancer is extremely rare, and its treatment strategy has not been established. In this report, we present a case of long-term survival after surgical resection and adjuvant chemotherapy for ascending colon cancer with synchronous isolated right external iliac lymph node metastasis.</p><p><strong>Clinical case: </strong>A 65-year-old woman with anorexia and anemia was referred to our hospital. Colonoscopy and computed tomography revealed a three-quarter circumferential type 2 tumor from the cecum to the ascending colon, along with regional and right external iliac lymph node swelling. We diagnosed ascending colon cancer with right external iliac artery lymph node metastasis. An open right hemicolectomy with D3 and right external iliac lymph node dissections were performed. Results of histopathological examination showed that both lymph nodes were metastasized from ascending colon cancer. The patient received eight courses of capecitabine and oxaliplatin therapy as adjuvant chemotherapy. At 60 months after surgery, the woman has not had a recurrence.</p><p><strong>Conclusions: </strong>Surgical resection and adjuvant chemotherapy may be an effective treatment strategy for synchronous isolated right external iliac lymph node metastases from ascending colon cancer.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 2","pages":"E52-E56"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501760/pdf/kobej-69-e52.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10314844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between Factor XIII Activity and Clinical Course in Pediatric Patients with Immunoglobulin A Vasculitis.","authors":"Hajime Tanaka, Tsukasa Tanaka, Oshi Tokuda, Hiroko Yamamoto, Natsuki Matsunoshita, Kanae Takenaka, Kenta Tominaga, Keiichiro Kawasaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin A vasculitis is a systemic form of vasculitis that predominantly affects children. Factor XIII activity is decreased in some cases, and several reports have shown an association between abdominal pain and decreased factor XIII activity. However, the clinical significance of decreased factor XIII activity in pediatric immunoglobulin A vasculitis has not been fully elucidated. This study aimed to identify the association between factor XIII activity and the clinical course of pediatric patients with immunoglobulin A vasculitis.</p><p><strong>Methods: </strong>Forty-four pediatric patients, admitted to Kita-Harima Medical Center with a clinical diagnosis of immunoglobulin A vasculitis between October 1, 2013 and September 30, 2022, were retrospectively reviewed, and 22 patients were analyzed. The patients' background characteristics and clinical course were compared between the normal and decreased factor XIII activity (<70%) groups.</p><p><strong>Results: </strong>The group with decreased factor XIII activity showed a significantly increased duration of hospitalization (14 [6-36] vs. 7 [5-13] days, p = 0.01), total glucocorticoid dose (prednisolone 22.7 [4.9-55.5] vs. 10.1 [3.4-19.6] mg/kg, p = 0.02), and duration of glucocorticoid administration (19 [4-85] vs. 10 [3-15] days, p = 0.03). Correlational analyses showed that these three parameters were negatively correlated with factor XIII activity.</p><p><strong>Conclusions: </strong>Factor XIII activity was negatively correlated with the duration of hospitalization, total glucocorticoid dose, and duration of glucocorticoid administration. Factor XIII activity is not only associated with abdominal symptoms but also may be a marker to predict the overall trajectory of acute-phase treatment in pediatric patients with immunoglobulin A vasculitis.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 2","pages":"E57-E63"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501757/pdf/kobej-69-e57.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}